COMMUNITY COLLABORATION - PREVENTION AND CONTROL OF TUBERCULOSIS IN AHOMELESS SHELTER

An urban shelter in Charleston, South Carolina developed and began a t uberculosis (TB) prevention and control plan that addressed the priori ties recommended by the Centers for Disease Control and Prevention. Af ter an increase in TB in the shelter in 1992, the local health departm ent, the homeless clinic nurse practitioners, and Medical University o f South Carolina College of Nursing faculty and students collaborated with the shelter staff to provide initial mass screenings for contact investigation. They also developed and implemented new policies and pr ocedures for an ongoing TB prevention and control program. The new pol icies required that guests obtain screening for TB within 7 days of ar rival at the shelter and every 6 months thereafter. Also, a public hea lth nurse began providing directly observed therapy twice weekly at th e shelter. Of the initial 22 persons who started TB preventive therapy in 1993, 17 (77%) completed therapy. The clinic nurse practitioners, nursing students, and public health nurses had important and defined r oles in the mass-screening process, case identification and treatment, policy development and implementation, health education, and establis hing methods of communication between the shelter, clinic, and health department. An ongoing health care community collaborative effort may successfully reduce tuberculosis disease in a homeless shelter populat ion.